Gynecologic oncology
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Gynecologic oncology · Sep 2007
Comparative StudyIntraperitoneal cisplatin and paclitaxel versus intravenous carboplatin and paclitaxel chemotherapy for Stage III ovarian cancer: a cost-effectiveness analysis.
To evaluate the cost-effectiveness of intraperitoneal cisplatin and paclitaxel chemotherapy as front-line treatment for patients with Stage III epithelial ovarian cancer following optimal primary cytoreductive surgery. ⋯ In this model, IP/IV chemotherapy was associated with a modest extension in quality-adjusted survival time but was also more costly than IV/IV chemotherapy. On balance, the IP/IV strategy can be considered a good healthcare value. However, these data also suggest that efforts to reduce the cost of IP/IV chemotherapy, such as through development of an ambulatory regimen with equivalent therapeutic efficacy but an improved toxicity profile, would improve the overall value of this adjuvant treatment program.
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Gynecologic oncology · Jul 2007
Use of systemic therapy in women with recurrent ovarian cancer--development of a national clinical practice guideline.
To develop a guidance document concerning the use of systemic therapy for women with recurrent ovarian cancer that would be applicable for the Canadian health care system. This will be done using a standardized systematic review process, guideline evaluation instruments, multi-disciplinary expert consensus opinion and evidence-rating systems. ⋯ The development of a national practice guideline on the use of systemic therapy for recurrent ovarian cancer was feasible using systematic literature review, expert consensus, guideline evaluation instruments, evidence-rating systems, independent internal and external review measures and final approval by a national discipline specific society (GOC). Recommendations for practice are offered.
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Gynecologic oncology · Jul 2007
Randomized Controlled Trial Multicenter StudyPrognostic factors for complete debulking in advanced ovarian cancer and its impact on survival. An exploratory analysis of a prospectively randomized phase III study of the Arbeitsgemeinschaft Gynaekologische Onkologie Ovarian Cancer Study Group (AGO-OVAR).
No residual tumor as result of primary surgery in advanced ovarian cancer is known as one of the most important prognostic factors. ⋯ Post-operative residual tumor is one of the most important independent prognostic factor for survival. Our results suggest an advantage for aggressive primary surgery and complete debulking. This surgical goal was achieved more often in experienced centers.
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Gynecologic oncology · Jul 2007
Comparative StudyExternal radiotherapy versus vaginal brachytherapy for patients with intermediate risk endometrial cancer.
To determine if brachytherapy alone is adequate adjuvant local therapy in patients classified as intermediate risk after complete surgical staging for endometrioid adenocarcinoma. ⋯ Vaginal brachytherapy alone results in minimal morbidity and is adequate local therapy for intermediate risk patients with endometrioid adenocarcinoma after complete surgical staging.